ABSTRACT
Spontaneous detachment is favored by interstitial pressure, osmotic pressure, and downregulation of cell–cell adhesion molecules. Dissemination of cancer cells does not always occur spontaneously. The expression of the adhesion molecules on the mesothelial cell surface is upregulated in case of inflammation after trauma or under the influence of disseminated cancer cells. While omental mesothelial cells inhibited adhesion, omental fibroblast induced adhesion and invasion. Cancer cell adhesion to the mesothelial layer after mesothelial to mesenchymal transition was stimulated. A perfect mimic of the peritoneal wall cannot be accomplished by in vitro adhesion assays. Survival of the disseminated cancer cell in the peritoneal fluid and its adhesion to the peritoneal wall are the first steps in peritoneal metastasis development. If disseminated cancer cells fail to survive or if their adhesion to the peritoneal wall can be inhibited, peritoneal metastasis formation may be prevented after removal of the primary tumor.
